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ORIGINAL

FEDERAL REPUBLIC OF NIGERIA

NATIONAL POPULATIONS COMMISSION

Certificate of Birth

Issued under the Birth and Deaths Act (Compulsory Registration) Decree 69 of 1992

Registration Center  
Town/village  
L.G.A  
State  

Certificate Number
  
  
Volume
  
Year
  
Entry No.

This is to certify that the birth details of which are recorded herein has been registered on

  
Day
  
Month
  
Year

at this registration Center

1. Full Name  
2. Sex  
3. Date of Birth //
4. Place of Birth  
5. Full Name of Father  

(Surname First)

6. Full Name of Mother  

(Surname First)

Place of Birth  
Date  
Name of Registrar  

Signature of Registrar

NATIONAL REGISTRATION PROGRAM

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